November 17, 2012

Direct Relief’s partner, Visitation Hospital in Haiti, has saved lives and provided care to more than 450 patients with the contents of their hurricane preparedness module and anticipate they will treat hundreds more in the coming days with health needs on the rise after Hurricane Sandy.

The module was sent to the Direct Relief warehouse in Port-au-Prince at the start of hurricane season so that it could be quickly utilized by our Haitian partners in those first critical hours and days after a hurricane strikes, without waiting for additional aid shipments, which are often delayed by logistical challenges. Each module contains enough medicines and supplies to treat up to 5,000 people for one month.

After Hurricane Sandy, roads were completely washed out and yet the hospital, which treats patients in the southwest of Haiti regardless of their ability to pay, saw an increase in the number of patients needing to be treated.

“Last week, a student came to the clinic in the afternoon with a stomach pain as she did not really eat in the morning before going to school, she was crying and could not breathe properly. When she came we quickly revived her with some Ensures donated by Direct Relief and gave her some medicines for her stomach,” reported Riphard Serent of Visitation Hospital.

Other medical interventions the hurricane module supported since its delivery last week was the delivery of a baby, treatment of severe dysentery and malnutrition, he said.

Additionally, he said there is a report of a cholera outbreak in Anse-a-Veau just ten miles south of the hospital. Products to treat cholera are especially useful at now, as the cholera treatment center was damaged Hurricane Sandy and patients are now seeking care at Visitation Clinic as an alternative.

ReliefWeb has just undergone a major improvement in its website. The new design is clean, clear, and readable. One glance at the home page and you already know more than you did a moment ago.

Moreover, a column down the right-hand side gives you access to updates in the last 24 hours (I've added a direct link to that page in the News Gatherers list), plus a list of 245 countries and territories that enables you to find out what's new in a particular country—and updates on current humanitarian disasters.

The site also has a blog, and I've added a link to it in the Bloggers list.

This new design greatly improves ReliefWeb's usability and impact, and I know I'll be spending a lot of time on the site, keeping up on stories that might otherwise go unnoticed.

GAYA: With less than a week left for the formal launch of the campaign to eradicate Japanese Encephalitis (JE) from Gaya and Aurangabad districts, the health department has geared up to meet the challenging job and the somewhat complex requirements of the effective maintenance of the immunization protocol including the cold chain and other mandatory precautions such as the temperature level of the child and use of the vaccine vial within two hours of its preparation.

Altogether 1,077 teams have been constituted for the immunization campaign. While 550 teams will be active in Gaya district, 527 teams will do the job in the Aurangabad district.

The precautions become all the more important as a similar exercise undertaken in Gaya district about two years back failed to deliver results necessitating another round of mass immunization of all the 23 lakh children in the vulnerable 1-15 age group. As per WHO estimates, no less than 15,000 children die of JE in Asia and many more suffer near permanent disabilities.

In 2011, altogether 94 JE patients died at ANMMCH, Gaya, alone and more than 200 survivors complained of mental retardation and acute weakening of the upper as well as lower limbs.

As per the brief given to the field officials engaged in vaccination drive over a period of three weeks beginning November 22, the vaccine has to be maintained at a temperature between 2-8 degrees Celsius and it is to be protected against direct sunlight. Protecting the vaccine from direct sunlight, according to health department sources, is going to be a challenging job particularly in the rural areas.

The vaccination protocol, besides prescribing the temperature and protection from sunlight also envisages the use of the vial within two hours of its opening. The prepared vaccine is not to be frozen.

Some precautions have also been prescribed including the likely effect of vaccine components like gelatin and gentamycin. Children having more than 100.4 degree F (38 degree Celsius) temperature are not to be vaccinated till temperature becomes normal.

FAUCHÉ, Haiti — A woman who lost just about everything now gives her children coffee for meals because it quiets their stomachs a bit. Another despondent mother relives the awful moment when her 18-month-old baby was swept from her arms by a flash flood. The bodies of a family of five killed in a mudslide still sit in a morgue unclaimed.

Haitians, who know well the death and despair natural disasters can cause, suffered mightily from Hurricane Sandy, which bashed the country’s rural areas and killed at least 54 people.

Three weeks after the hurricane’s deluge, Haiti, still struggling to recover from the earthquake in January 2010, is facing its biggest blow to reconstruction and slipping deeper into crisis, United Nations and government officials say, with hundreds of thousands of others at risk of hunger or malnutrition.

All around this hamlet and others nearby, the men and women who farmed bananas, plantains, sugar cane, beans and breadfruit stare at fields swept of trees, still flooded or coated with river muck that will probably kill off whatever plants are left. They had little, have endured much, and now need more. Hardened by past disasters, they still fear the days and weeks ahead.

“I do not know where we will find money for food and school now,” said Olibrun Hilaire, 61, surveying his wrecked plantain and sugar cane farm in Petit-Goâve that supported his family of 10 children and grandchildren.

As if the quake were not enough, Haiti is now suffering the combined onslaught of storms and, before that, drought, imperiling its food supply, causing $254 million in agricultural losses and throwing 1.6 million people — about 16 percent of the population — into dire straits.

Tropical Storm Isaac in August destroyed farms in the north, preceded by a spring drought that devastated farms there. Then came Hurricane Sandy, which passed west of Hispaniola and over Jamaica but was large enough to send 20 inches of rain over southern Haiti.

Last week, as the government and the United Nations took stock of the storm and grappled with flooding in the north from a fresh cloudburst that left 10 people dead, they issued an emergency appeal for $39 million in humanitarian aid to a world weary of its recurrent disasters. United Nations officials said they had received pledges for about $8 million, and the Haitian government said it was in talks with donors to raise at least half the requested amount.

“This is a major blow to Haiti’s reconstruction efforts, making life for most vulnerable Haitians even more precarious,” said the United Nations humanitarian coordinator in Haiti, Nigel Fisher. “International partners’ ability to respond has been reduced by dwindling donor support,” he added.

The recent storms have damaged or destroyed 61 cholera treatment centers, leading to fears that there may be fresh outbreaks of an epidemic that has already killed more than 7,500 people since 2010.

The storm’s rare direct strike on the New York metropolitan area was devastating, but the heartache here, too, is wrenching and the recovery years off, if it happens at all.

MSPP has posted another five days' worth of cholera statistics on its Documentation page, taking us from November 8 to 12. As usual, the daily numbers don't tell the same story as the cumulative totals from the start of the outbreak 25 months ago in October 2010.

On November 7, the last previous date with statistics, the cumulative total was 611,728. For November 8, the number jumps by 1,307 to 613,035. The daily total was itself very bad, 388, but MSPP clearly had to add in a lot of delayed departmental numbers.

Similarly, cumulative total deaths on November 7 had been 7,661. Three persons died on the 8th, but the cumulative deaths rose by 18.

By November 12, the cumulative case total was 614,196—a rise of 2,468, while the daily totals for November 8-12 added up to 1,594. Deaths for these five days were up 16, but the cumulative deaths were up 30, to 7,691.

So Haiti's time of cholera is now into its third year. As of November 12, MSPP has reported 90,203 cases of cholera and 643 deaths this year. That's an average of 284 cases a day, and 2 deaths a day. In the remaining 49 days of the year from November 12, at this rate, Haiti will see another 13,916 cases by December 31, for a total of 104,119. Another 98 Haitians will die of cholera, for a total of 741.

Those numbers are relatively low compared to the first year of cholera. On October 31, 2010, MSPP had recorded 6,049 cases and 417 deaths—an appalling number when the outbreak was only about two weeks old. By October 30, 2011, another 483,186 cases had been reported, and another 6,316 deaths.

I guess we can safely say that whatever the true numbers may be, cholera is now endemic in Haiti.

Cayo Leveau, Ucayali director of epidemiology, said that the victim, Pamela Tananta, was hospitalized last Tuesday; he called on the public to visit health centres quickly if they have symptoms of the disease.

The Ministry of Health (MoH) of Uganda has notified WHO of an outbreak of Ebola haemorrhagic fever in Luweero district in Central Uganda.

Four cases, including 3 fatal, have been reported. Samples were taken from two cases, for which laboratory confirmation of Ebola virus (species Sudan) was made by PCR and serology tests at the Uganda Virus Research Institute (UVRI) in Entebbe.

The Ministry of Health, WHO and Médecins Sans Frontières (MSF) have sent a team to conduct preliminary investigation into the outbreak. Health authorities are conducting active case search and tracing close contacts of the confirmed and probable cases.

The isolation facility at Mulago hospital in Kampala is reactivated and another isolation facility at Nyimbwa Health Center IV at the epicenter is being established. The military hospital in Bombo, Luweero district is also serving a holding center until the isolation facility is properly set up at the Nyimbwa Health Center IV. Seven close contacts of the cases have developed symptoms and are being isolated in the isolation facilities.

WHO and partners, including the Centers for Disease Control and Prevention (CDC), the Uganda Red Cross (URCS), African Field Epidemiology Network (AFENET) and Médecins-Sans-Frontières (MSF) are supporting the authorities in the response activities.

Experts in the area of field epidemiology, health promotion, logistics management, and infection prevention and control are being identified to provide additional support through the Global Outbreak Alert and Response Network (GOARN).

With respect to this event, WHO does not recommend that any travel or trade restriction be applied to Uganda.

The head of a unit which has been investigating the Cambodian government's National Malaria Center on behalf of the country's largest healthcare donor was sacked Thursday for "unsatisfactory performance."

John Parsons, the inspector general for the Global Fund to Fight AIDS, Tuberculosis and Malaria, was fired by the $23 billion fund following a thorough review of his work, the organisation's board wrote in a statement issued Thursday.

Though the specific reasons for his dismissal have yet to be publicised, Parson's firing was slammed by the world's largest HIV/AIDS organization, which accused the Global Fund of likely "being uncomfortable having its shortcomings so exposed,” according to Tom Myers, AIDS Healthcare Foundation's general counsel.

Parsons had oversight of the Office of the Inspector General – which for the last 18 months has been investigating the fund's Cambodia programs amid allegations of corruption. Earlier this week, the Global Fund revealed it had found evidence of significant financial wrongdoing and announced it would no longer be funneling money directly through the Cambodian government's malaria center.

A report on the Global Fund findings is expected in a matter of weeks and a spokesman on Friday insisted that despite qualms surrounding Parsons' abilities, the quality of the Cambodian investigation had not been compromised in any manner.

"The Board's decision to dismiss him does not invalidate or interrupt ongoing investigations. It will not affect the forthcoming report," said communications department head Seth Faison.

According to sources with knowledge of the investigation, the fund had uncovered significant corruption within the National Malaria Center. In an internal report of the findings thus far, the fund late last month warned that the Center's mismanagement had caused risks to the medication supply and finances.